Primary and Secondary Control Enhancement Training (PASCET)

Primary and Secondary Control Enhancement Training (PASCET) is a program for treating mild to moderate depression in elementary school children. The therapy is conducted in a classroom during school hours, and teaches the children techniques for feeling in control of their lives and managing their moods. A small-scale experimental study found that the symptoms of children who received the training decreased twice as much as those who did not, and this impact was still apparent nine months after the intervention.

DESCRIPTION OF PROGRAM

Target population: Late elementary-school children with mild to moderate depressive symptoms.

PASCET is a school-based therapy intervention designed to reduce depressive symptoms in young children. The intervention consists of eight 50-minute small-group sessions that aim to teach the children five main skills: how to actively choose to do things that they enjoy; setting goals and practicing skills that they value; changing thoughts that lead to depressive symptoms; using cognitive techniques to improve their mood; and using relaxation and positive imagery to combat bad feelings. The therapy is conducted with groups of up to six students, and it includes role-play, games, and videos in the sessions. There are also weekly homework assignments, as well as a one-on-one session near the end to apply the lessons learned to individual circumstances.

Evaluated population: The sample for this evaluation consisted of 48 children in grades 3 through 6 (from three elementary schools) who showed depressive symptoms on at least one of two evaluations. Participants included 26 boys and 22 girls; 30 were white and 18 were non-white (mostly African American). On average, they were nine-and-a-half years old, in the 91st percentile for symptoms on the first test for depression (Children’s Depression Inventory ,CDI), and in the 93rd percentile on the second test for depression (Revised Children’s Depression Rating Scale, CDRS-R).

Approach: After selecting the study sample, children were randomly assigned to either the treatment or control group, with one-third of the children in the treatment group. The treatment lasted approximately two months and was conducted at each child’s school, in a classroom. At pretest, within 18 days of the last treatment session, and also nine months after treatment, children completed the CDI for themselves and were administered the CDRS-R by an adult; both are measures of depressive symptoms. No differences were found between the treatment and control groups in terms of demographics or outcomes at baseline. Forty percent of the sample was not re-evaluated at the nine-month follow-up, but no differences in demographics or pretest outcomes were found among those who were not included.

Results: While depressive symptoms decreased for both groups, the change was significantly greater (twice as large) for children in the treatment group. A significant difference was found on both the CDI and CDRS-R measures of depressive symptoms. The impact was still detectable at nine months after treatment. There were no significant differences by gender, race, or class group.